[Hifred]

I just read the Villages Magazine about health care and was wondering who to write regarding an issue I have had with the health care system. What my husband and I as well as several neighbors have experienced is that indeed The Villages is uping their game on hiring new doctors. We were delighted with our first visits and were looking forward to receiving good care. What we found to be substandard is following the initial visit no matter what the severity of the problem we experienced we were only allowed to see a physician assistant (PA) as our doctor was fully booked. The PAs have made mistakes with diagnosing and ordering tests. They are not physicians and even the doctor after seeing the tests ordered that we paid for acknowledged the PA made an error. What I would like to propose is that TV start a concierge medical program where you are guaranteed to see a real live doctor when you need one. I have a history of cardiac issues (two heart procedures and one heart and lung procedure). When I needed to see a cardiologist I couldn't get an appointment in TV so I ended up calling my doctor at Northwestern in Chicago who immediately fed ex'd me a monitor and his nurse went over a video of how to put it on. I had my problem fixed within a week. Where as I would have had to wait weeks to even see a doctor here. I would definitely be willing to pay for concierge medicine. The other thing is that specialists and primary care doctors I saw in Chicago had Master's in nursing with additional training in their specialty area who would review email questions and discuss with the doctor what course of action was needed. Here in TV and at Shands if I call with a question for a specialist the person handling the question is a CNA who doesn't begin to be able to make the determination of the seriousness of the problem. As a next step to world class medical care I would like to ask:

1) Can they examine protocols and put in place basic procedures to insure proper care? i.e. at TV the nurse who took my husband's blood did not even put a label on the tube of blood. She said she was going to do it as soon as she was done with us. She didn't even write his name on the tube. The protocols here are loosie goosey and are poor medical practice. When the results came back they didn't even resemble my husband's past blood work results with elevations he had never had before. We ended up at Shands and new blood work was done. The two results were not even similar. So we ended up paying for two sets of blood work rather than relying on the one taken at TV.

2) Can they guarantee patients can see a doctor by assigning less patients per doctor and reserving some spots daily for doctors to see emergency patients rather than relying on PA's? Or at least allow patients to see a doctor rather than a PA. At Northwestern Memorial if your primary doctor can't see you, you always see an MD not a PA. I understand this level of care costs more but I am willing to pay for it. I have private insurance and would gladly pay to see an experienced doctor over a PA.

3) If they can't do step 2 would they be willing to have an MD review the PA's recommendation instead of having them order tests? In our case we paid a lot of money and were sent for the wrong tests because the PA didn't know he was ordering a useless test for the symptoms my husband had. This significantly delayed treatment and he required additional work ups. The cost for the useless test was more than $500 after our insurance.

No one wants better health care in TV than I. Can't they develop a higher level of care than what exists at present? Who can I write to for an answer?

[ThirdOfFive]

Originally Posted by Hifred

I just read the Villages Magazine about health care and was wondering who to write regarding an issue I have had with the health care system. What my husband and I as well as several neighbors have experienced is that indeed The Villages is uping their game on hiring new doctors. We were delighted with our first visits and were looking forward to receiving good care. What we found to be substandard is following the initial visit no matter what the severity of the problem we experienced we were only allowed to see a physician assistant (PA) as our doctor was fully booked. The PAs have made mistakes with diagnosing and ordering tests. They are not physicians and even the doctor after seeing the tests ordered that we paid for acknowledged the PA made an error. What I would like to propose is that TV start a concierge medical program where you are guaranteed to see a real live doctor when you need one. I have a history of cardiac issues (two heart procedures and one heart and lung procedure). When I needed to see a cardiologist I couldn't get an appointment in TV so I ended up calling my doctor at Northwestern in Chicago who immediately fed ex'd me a monitor and his nurse went over a video of how to put it on. I had my problem fixed within a week. Where as I would have had to wait weeks to even see a doctor here. I would definitely be willing to pay for concierge medicine. The other thing is that specialists and primary care doctors I saw in Chicago had Master's in nursing with additional training in their specialty area who would review email questions and discuss with the doctor what course of action was needed. Here in TV and at Shands if I call with a question for a specialist the person handling the question is a CNA who doesn't begin to be able to make the determination of the seriousness of the problem. As a next step to world class medical care I would like to ask:

1) Can they examine protocols and put in place basic procedures to insure proper care? i.e. at TV the nurse who took my husband's blood did not even put a label on the tube of blood. She said she was going to do it as soon as she was done with us. She didn't even write his name on the tube. The protocols here are loosie goosey and are poor medical practice. When the results came back they didn't even resemble my husband's past blood work results with elevations he had never had before. We ended up at Shands and new blood work was done. The two results were not even similar. So we ended up paying for two sets of blood work rather than relying on the one taken at TV.

2) Can they guarantee patients can see a doctor by assigning less patients per doctor and reserving some spots daily for doctors to see emergency patients rather than relying on PA's? Or at least allow patients to see a doctor rather than a PA. At Northwestern Memorial if your primary doctor can't see you, you always see an MD not a PA. I understand this level of care costs more but I am willing to pay for it. I have private insurance and would gladly pay to see an experienced doctor over a PA.

3) If they can't do step 2 would they be willing to have an MD review the PA's recommendation instead of having them order tests? In our case we paid a lot of money and were sent for the wrong tests because the PA didn't know he was ordering a useless test for the symptoms my husband had. This significantly delayed treatment and he required additional work ups. The cost for the useless test was more than $500 after our insurance.

No one wants better health care in TV than I. Can't they develop a higher level of care than what exists at present? Who can I write to for an answer?

I am pretty sure that The Villages doesn't hire doctors; just like everywhere else they are employed by independent health-care entities with practices on The Villages. If you have a complaint about the quality of your medical service through the one you use, be it with your doctor, the PA's or any other part, I am sure that the organization has a complaint department. In today's connected world, especially in an environment such as The Villages, both good and bad experiences shared online make the rounds pretty quickly and I doubt that your health-care provider wants negative reviews going around.

Check their website. My guess is that it will be pretty easy to find how to file a complaint with them.

[villagetinker]

Now you know why we dropped Villages Health System, and went back to Medicare and local doctors, sorry for your experience. If you have been in the VHS for less than a year you should be able to get out with out underwriting HOWEVER you will probably experience a delay in getting your new doctors set. There was a practice that was offering a concierge care program, I was not interested and so not remember, however it was quite expensive as I recall.
I wish you good luck.

[Bogie Shooter]

How can the members of TOTV possibly answer your proposed changes?
Your post should be put in a letter to The Villages Health.

[Number 10 GI]

All our doctors are outside TV. They have provided us with very good health care. Get out of the bubble!

[villagetinker]

OP, sorry, I should have included that the Villages Health System is privately owned, by the Developer (I think). You should be able to go to anyone of the Health Care Centers and get a copy of the upper management team, and then contact an appropriate individual. I had tried this a few years ago when VHS decided to stop the grandfathered Medicare option for coverage, I did not get anywhere.

[golfing eagles]

Originally Posted by villagetinker

OP, sorry, I should have included that the Villages Health System is privately owned, by the Developer (I think). You should be able to go to anyone of the Health Care Centers and get a copy of the upper management team, and then contact an appropriate individual. I had tried this a few years ago when VHS decided to stop the grandfathered Medicare option for coverage, I did not get anywhere.

I agree----make a complaint to the Villages Health System management. There is little point in complaining to a magazine (or on this site for that matter)

[Blueblaze]

So far, VHS has not impressed me. But neither have the specialists they've sent me to.

During my one yearly check up with my new VHS primary care doctor, I mentioned that it had been more than five years since I'd had a stress test. So instead of just scheduling the test, he sent me to a VHS cardiologist (to collect another fee, I guess). The cardiologist collected my copay and then informed me they don't do stress tests anymore, but instead use a CT scan to look for plaque in my heart. So he sent me to Lake Radiology, where I paid yet another specialist copay for a radiologist to agree that I needed a CT scan to screen for heart disease, based on the fact that I use statins to control my cholesterol.

My insurance, United AARP Medicare Advantage, states in all the plan documents that cardiac screening tests are covered 100% with no copay.

So, naturally, the radiologist used a "diagnostic" code rather than a "screening" code to file the insurance claim, while specifying in English that it was a cardiac screening test.

So naturally, United rejected the claim, since the $103 was less than the $150 copay for radiology diagnostics.

I opened a case with United, who contacted Lake to inform them that they had used the wrong code, who then performed an "investigation", which determined that they had used the correct United code for a cardiac screening. Apparently, Lake Radiology is the authority on United insurance codes, not United Healthcare.

So I personally called Lake, managed to get through to a "supervisor" (after arguing with a brick wall for half an hour), who informed me that they had no intention of refiling, despite the fact that both United and Lake agree that it was a screening test and not a diagnostic, and United had given them the correct code and told them they would happily pay the claim if they would just file it correctly. I pointed out that I would not be paying, United offered to pay, and their own stubbornness had wasted far more than $103 of their time on phone calls and "investigations", which seemed absurd when United had offered from the start to pay the bill.

But brick walls don't have minds to change, so I was forced to give up. I guess Lake will not be getting their $103.

Can't wait for January to get out of this goofy system.

[Hifred]

We are seen through The Villages Health. The Villages magazine focus this month was on the Health Care at The Villages Health. My comments were directed to The Villages Health.

[Hifred]

Agreed. That is why I was asking who do I send my comments to. I was hoping someone could provide direction on who I should write to.

[OrangeBlossomBaby]

Originally Posted by Hifred

We are seen through The Villages Health. The Villages magazine focus this month was on the Health Care at The Villages Health. My comments were directed to The Villages Health.

If you are directing your comments to the Villages Health, you're doing so in the wrong venue. Talk of the Villages is not an official website of the Villages, and there is no "official" person here from the Villages Health who can help you or who will even see your post. You should take villagetinker's advice in post #6.

[Traveling lady]

I think if you see a PA you should be charged less than if you see an MD. You are not getting the same level of care, education, or experience.

[golfing eagles]

Originally Posted by Hifred

Agreed. That is why I was asking who do I send my comments to. I was hoping someone could provide direction on who I should write to.

This might be a starting point:

Administrative Offices
1149 Main St.
Lady Lake, FL 32159
352-674-8905

TVH Corporate Office
Corporate Office
1020 Lake Sumter Landing
The Villages, FL 32162
352-674-1700

[eeroger]

The only concierge doctor in The Villages is of no help. For $1800 per year out of your pocket, you get sent to multiple for tests and see multiple specialists with little follow up from primary care doctor. She does not manage your care unless you can come into the office. I thought a primary care doctor was supposed to help you manage or coordinate care among the specialists. I guess that is no longer the case.

[golfing eagles]

Originally Posted by eeroger

The only concierge doctor in The Villages is of no help. For $1800 per year out of your pocket, you get sent to multiple for tests and see multiple specialists with little follow up from primary care doctor. She does not manage your care unless you can come into the office. I thought a primary care doctor was supposed to help you manage or coordinate care among the specialists. I guess that is no longer the case.

Is this post a bit contradictory?
(and off topic)